Penile Inverted Skin Flap & Recto-Sigmoid Colon Techniques

Dr Kim performs gender reassignment surgery (GRS) at South Korea's National Medical Center (NMC) or at his clinic, depending on the procedure and the details of the case.

Vaginoplasty: Penile Inverted Skin Flap & Recto-Sigmoid Colon Techniques

He accepts HIV-positive homosexual and heterosexual transgender patients seeking male-to-female transsexual sexual reassignment surgery (SRS).

Costs are straightforward and transparent. There are no hidden costs.

The surgeon speaks, understands, reads and writes English well. No communication problems.

There are two basic costs: the surgeon's fee and the hospital fees, if the surgery is not done at the clinic.

The surgeon's fee is paid in US dollars cash.

The hospital fees can be paid by credit card and the National Medical Center (NMC) prefers that.

Male to Female Surgery Cost

The surgeon's fee for vaginoplasty from recto-sigmoid segment (including clitoroplasty and labiaplastyis) is US$10000 for patients who have had no previous bottom surgery.

NMC charges US$400/night for a private room, US$200/night for a bed in a 6-person ward. There will be various additional charges by the hospital such as anesthesia.

Actual cost depends directly on the strength of the patient and how many nights she must stay in hospital.

NMC hospital fees will be less than US$16000 (approximately), including anesthesia.

Surgery takes eight hours.

The patient is expected to stay approximately six nights in the National Medical Center. Longer stay in hospital is sometimes recommended.

Patients are expected to stay at least 3-4 weeks in Seoul for recovery after surgery. Dr Kim recommends four.

Penile Skin Inversion or Colon?

Male-to-female reassignment is best done using either skin or bowel to create the neovagina.

Vaginoplasty by penile skin inversion with clitoroplasty and labiaplasty is also available. That requires at least two weeks recovery in Seoul.

Using skin instead of colon segment is suitable if you do not expect to have sexual intercourse — or your sex partner has a relatively small penis.

Surgery from recto-sigmoid segment is appropriate if you have already had penile skin inversion vaginoplasty performed but discovered it provides insufficient vaginal depth for good sexual intercourse.

Surgeons who push penile skin inversion surgery because of the lower cost to the patient often say that postoperative vaginal stenting and periodic dilatation will enable sexual intercourse. A significant number of patients find that is not true.

The procedure requires less time to perform and is less challenging and less complex than creation of a vagina using a rectosigmoid segment which is aesthetically pleasing and much more suitable for sexual activity — including with men who have a 9, 10 or 11 inch penis.

Dr Kim explains:

Penile inversion vaginoplasty costs US$12000.

The surgery can be performed using an epidural. If you want general anesthesia instead, then that costs US$2000 more.

You will need to stay at the clinic 4-7 nights. The exact number of nights depends on the speed of your recovery.

After discharge from the clinic, you will need to return to the clinic daily for dilation and dressing change.

A urinary catheter will need to be implanted for two weeks. It can be safely removed following complete healing of the wound.

Before having surgery, you should have no hair on your scrotum. Pre-operative total depilation by laser is medically indicated or you will develop a hairy neo-vagina.

The surgery lasts 5-6 hours but sometimes up to eight hours.

An orchieotomy is included in the vaginoplasty surgical package.

Gender affirming surgery (gender transition surgery, gender reassignment surgery) by way of skin inversion technique vaginoplasty includes orchiectomies, penectomy, labioplasties, clitoroplasty, vestibuloplasty and vaginoplasty.

All bottom surgery needs more than 12 months of prior consecutive cross hormonal therapy.

In some countries, for example Japan, doctors recommend separating orchiectomy surgery from vaginoplasty and doing it first.

If you want the orchieotomy done separately, then it costs US$1500.

Important: Laser hair removal must be repeated many times over a substantial period of time to eliminate all hair.

The surgical fee is paid in cash directly to Dr Kim but a credit card can be used for the hospital, accommodations and almost everything else, including restaurants, taxis, supermarkets and mini-marts.

HIV-positive patients should get the four major categories of blood tests done in their hometown and then have a physician issue a medical report stating you are strong enough for surgery. The medical affidavit can be from your endocrinologist, GP, family doctor or any other medical doctor.

Post-operative erotic sensation is preserved by re-engineering the glans into the clitoris. That means ability to have an orgasm after surgery will follow the ability you have before surgery. Tactile sensation in the genital area will be normal when recovery from the surgery is complete.

Male to Female Transition: How To

To schedule an appointment for surgery, Dr Kim requests that you provide him with:

  1. a surgery date proposal at least one week in advance;
  2. a medical history;
  3. digital copies (scans) of the original letters from psychiatric or mental health professionals to Dr Kim diagnosing you as suffering from Gender Dysphoria, also know as Gender Identity Disorder (GID) and authorizing surgical correction by male organ removal and vaginoplasty (if it is your first bottom surgery).

    These signed documents on the mental health professional's official stationary and containing full contact information are required by The World Professional Association for Transgender Health (WPATH) Standards of Care (SOC) to which Dr Kim chooses to adhere. You should hand-deliver the original letters to the surgeon when you meet him in Seoul.

    The latest version of the Standards of Care in PDF format are available in these languages. Click to download.
  4. No scheduling fee is charged.

Male to female transsexual patients coming for revision, or corrective vaginoplasty, no longer need psychiatric authorization for gender reassignment, as in the case of vaginoplasty from recto-sigmoid segment to replace penile skin inversion vaginoplasty.

At the beginning of 2021, Dr Kim is performing surgery as usual. You will need to arrive in Seoul with a fresh, new NEGATIVE CoVID test result that was administered not more than 72 hours before departure from your place of disembarkation.

After arrival in Seoul, the government will require you to isolate for two weeks.

When you emerge from quarantine, you can meet see Dr Kim for your consultation, pre-op tests and get surgery.